Crisis in County Health Care

Re "Cutbacks Fray 'Thin White Line,' " Oct. 31: There is no mystery why these cutbacks at the Harbor-UCLA Medical Center are occurring. You quote one physician as stating: "Everyone here is in poverty, which means they're all at risk for serious disease. I love it because it uses more of my skills." This physician, of course, is out of contact with reality.

The arithmetic is simple. Last year, California lost 426,000 residents while taking in well over 200,000 foreign immigrants, many of whom are impoverished but nevertheless have large families. Minimum-wage incomes of $9,000 per year are simply not adequate to provide the tax base necessary to support a high-quality medical care system--nor, for that matter, a high-quality educational system.

Cliches such as "we are a nation of immigrants" and the like are not going to solve these problems. As any child who can add and subtract will tell you, there is simply no way that First World health and educational systems can be maintained by a society that is increasingly composed of individuals with Third World incomes.

GEORGE RAYMOND TYNDALL MD

Los Angeles

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On several occasions now, I have read with consternation about the "lucrative stipends" being collected by physicians at County-USC Medical Center over and above their "40-hour week" assignments (Oct. 29). I am a full-time USC faculty physician, with resident and medical student teaching responsibilities in the hospital and medical school. I am paid nothing for any of my teaching duties, though they can take 10 or more hours a week.

All of my duties at the hospital are documented on time-audit reports and are subject to continuous review. I am paid under $40 per hour for my expertise when I am there; certainly less than I can obtain in private practice. My family and I are partners with the USC School of Medicine in the commitment made to medical education and health care for our Los Angeles community, insured and underinsured.

Please, give us more details about this enormous slush fund; my wife (also a physician, working for the Department of Health Services) and I have more than $250,000 to pay off from our USC medical school education costs and we could use the extra money!